Attitudes towards lung cancer screening in a population sample

Background: Lung cancer is the leading cause of cancer death worldwide. Routine UK lung cancer screening is not yet available, thus understanding barriers to participation in lung screening could help maximize effectiveness if introduced.

Methods: Population-based survey of 1007 adults aged 16 and over in Wales using random quota sampling. Computer-assisted face-to-face interviews included demographic variables (age, gender, smoking, social group), four lung cancer belief statements and three lung screening attitudinal items. Determinants of lung screening attitudes were examined using multivariable regression adjusted for age, gender, social group and previous exposure to lung campaign messages.

Results: Avoidance of lung screening due to fear of what might be found was statistically significantly associated with negative lung cancer beliefs including fatalism (aOR = 8.8, 95% CI = 5.6-13.9, P ≤ 0.001), low perceived value of symptomatic presentation (aOR = 2.4, 95% CI = 1.5-3.9, P ≤ 0.001) and low treatment efficacy (aOR = 0.3, CI = 0.2-0.7, P ≤ 0.01). Low perceived effectiveness of lung screening was significantly associated with fatalism (aOR = 6.4, 95% CI = 3.5-11.7, P ≤ 0.001), low perceived value of symptom presentation (aOR = 4.9, 95% CI = 2.7-8.9, P ≤ 0.001) and low treatment efficacy (aOR = 0.1, 95% CI = 0.1-0.3, P ≤ 0.001). In contrast, respondents who thought lung screening could reduce cancer deaths had positive beliefs about lung cancer (aOR = 0.4, 95% CI = 0.2-0.7, P ≤ 0.001) and its treatment (aOR = 6.1, 95% CI = 3.0-12.6, P ≤ 0.001).

Conclusion: People with negative beliefs about lung cancer may be more likely to avoid lung screening. Alongside the introduction of effective early detection strategies, interventions are needed to modify public perceptions of lung cancer, particularly for fatalism.